Tag Archives: relationships

Essential skill development for meaningful social connection

By Lisa Compton and Taylor Patterson September 18, 2023

A group of adults sitting around a table drinking coffee and smiling


Research has identified the important role social connectivity plays in mental wellness. As trauma experts, we also recognize how attachment deficits and trauma wounds can impact components of making and maintaining relationships.

Attachment deficits may cause people to seek friends and partners who possess similar characteristics to their insecure attachment figures (such as partnering with abusive or emotionally unavailable individuals). These deficits may also result in people prioritizing their own attachment needs above the needs of others (as in the case of narcissistic relationships), or they may cause people to disregard their own boundaries to maintain relationships at any cost (such as in codependent relationships).

Unresolved trauma wounds can interfere with healthy connectivity when our survival defense systems are in overdrive trying to protect us from pain. We may react with hypervigilance and misinterpret interactions as potential threats, have difficulty trusting others, maintain rigid boundaries to avoid intimacy, or simply overreact or underreact emotionally to situations. Past trauma can cause both emotional and physiological changes that interfere with social connection. The survival reactions of fight, flight or freeze direct bodily resources to respond to the crisis and move away from activities unnecessary for immediate survival, such as digestion and higher-order functions of the prefrontal cortex. The limited operation of the prefrontal cortex reduces our capacity for executive functions such as reasoning and communication, which are important components in navigating relationships. This reduction in executive function can happen during an actual trauma or may be triggered by a sensation associated with the trauma.

Counselors play a significant role in clients’ social skill development, increasing their potential to interact intentionally and not reactively from defensive responses. To help facilitate these discussions, we created the meaningful connection skills pyramid, a clinical tool counselors can use with clients who have insecure attachment and trauma histories (see Figure 1). This tool identifies six developmental skills that function in a progressive, developmental path toward meaningful connection and aid in intentional interactions: self-awareness and assessment, self-soothing to calm nervous system arousal, connection of past events to current triggers, reciprocal interactions, boundary enforcement, and rupture and repair.

Meaningful connection skills pyramid

Figure 1: Meaningful connection skills pyramid by Lisa Compton and Taylor Patterson

In the following sections, we illustrate how counselors can use this tool with a hypothetical example: Alicia comes to counseling after she has a significant argument with one of her close friends. When she was scrolling through social media, she discovered that her friend attended a party without her. Alicia was so upset that she called her friend and accused her friend of not caring about her or their friendship. Then Alicia blocked the friend’s phone number and social media accounts. Alicia’s history of trauma has disrupted her ability to reason, communicate with her friend, hear other possible explanations for why she wasn’t invited or work through the relational rupture.

Increasing self-awareness

Self-awareness is a foundational skill in social connection. Socially intuitive individuals can remain aware of internal cues (i.e., awareness of internal states) and external cues (i.e., awareness of how they come across to others). Clients may be interoceptive, the internal awareness of what is happening in the body (e.g., heart racing, feeling a “pit” in the stomach), or neuroceptive, the ability to assess external cues of safety or threat in the context of relationships. For example, an employee may notice that their chest is tight as they approach an important performance review at work (interoception). When they enter the conference room, the boss provides cues of warmth and approachability by smiling, leaning back in their chair and greeting the employee in a friendly manner (neuroception); these cues enable the employee to intentionally engage in calming behaviors and remain grounded throughout the meeting. By increasing our internal and external awareness and recognizing when we are in a threat response mode, we can work toward feeling safe and changing our defensive reactions.

Counselors can use assessment tools to help clients notice, evaluate and describe their level of distress and social connection. Here are three self-assessments we recommend using with clients:

  • Subjective Units of Distress Scale: This self-assessment tool allows clients to quantify their level of distress on a scale from zero to 10.
  • Body scans: This method asks clients to pay attention to parts of their body and bodily sensations, starting with their feet and moving up to their head. Body scanning helps strengthen clients’ ability to practice interoception.

Zipper screening tool image of zippers

Zipper screening tool description of zipper images

Figure 2: Zipper screening (a self-assessment tool created by Lisa Compton)

  • Zipper screen: I (Lisa) created this tool to help clients quickly assess and describe their current perceptions of social connection (see Figure 2). Counselors ask clients, “How ‘zipped’ or connected to others do you feel right now?” Clients then respond using the metaphor of a zipper to describe how connect they feel: zipper broken (disconnected), zipper functional but unzipped (lonely but hopeful), partially zipped (interacting but unsatisfied) and fully zipped (connected and fulfilled). Clients can also create their own metaphors such as “zipper stuck in the fabric lining” to represent feelings of enmeshment and other distressful forms of connection.
  • Window of tolerance: Clients can use this tool to evaluate their current arousal levels. The window of tolerance describes the optimal arousal zone (also considered “equilibrium”) between hyperarousal and hypoarousal, where clients remain regulated and the prefrontal cortex is active and functioning optimally. We recommend counselors use a color code to simplify the use of this tool: red for hyperarousal, green for optimal zone and gray for hypoarousal. With this method, clients do not need to remember the terminology; instead, they can respond using colors to indicate how they feel: green (“go” or move forward with treatment), red (too hot and need to cool down) or gray (lethargic and need to be energized). Counselors can teach clients how to expand their window of tolerance through emotion regulation activities and early identification of triggers.

We can help our hypothetical client, Alicia, increase her awareness of physiological cues of distress (interoception) and external cues of safety or danger (neuroception) using these tools. For example, the counselor could have Alicia take the Subjective Units of Distress Scale and reflect on the intensity of her distress at various points in her conflict with her friend (e.g., before seeing the social media post, during the phone call, after blocking her). In addition, the counselor could ask Alicia to identify what sensations she was feeling in her body at each of these points (e.g., stomach felt nauseous, chest was tight, face felt warm). Alicia could also consider what external cues contributed to her distress (e.g., the social media post, her friend’s tone of voice).

Calming the nervous system

It is common for clients with a history of insecure attachment or trauma to try to restore emotional and physiological equilibrium through maladaptive emotion regulation strategies. This can often prompt unhelpful oscillation between hyperarousal and hypoarousal.

For example, because of her traumatic experiences, Alicia finds herself constantly scanning her friendships for perceived rejection. This creates a state of hyperarousal and often intense symptoms of anxiety. To manage her hypervigilance, she drinks heavily in social situations in an attempt to calm her anxiety. The counselor can work with Alicia to help her identify her reactivity. Then she will be able to consider more adaptive emotion regulation strategies, including regulated breathing, progressive muscle relaxation and grounding exercises.

Connecting past events to present triggers

When clients have an emotional response that seems disproportionate to the present circumstances, they are likely reacting to past trauma wounds or attachment deficits. As clients learn to regulate their nervous system arousal, they can begin to cognitively connect their reactivity to specific triggers related to past events.

It’s understandable that Alicia would feel disappointed or confused when she discovered she was not invited to a party, but an amygdala-initiated survival response of fight, flight or freeze does not seem to correspond with the present threat. Once Alicia identifies her reactivity, she can explore past events potentially connected to her current trigger. For example, maybe past experiences of rejection led to negative core beliefs about Alicia’s self-worth, such as “I’m unlovable,” “I’m defective” or “I’m invisible.” In this case, modalities such as eye movement desensitization and reprocessing and cognitive behavior therapy can help clients such as Alicia identify origins of triggers, examine negative core beliefs associated with these memories, and instill more adaptive beliefs to promote healing from past trauma wounds and decrease reactivity to present triggers.

Engaging in reciprocal relationships

Insecure attachment can become trauma responses if the person has unmet needs in infancy and early childhood. Parental responses to infant distress create relational structures that affect how the infant learns to relate to their caregivers and others. Insecure attachment is characterized by chronic misattunement to a child’s needs or emotional experience and can be experienced by the child’s nervous system as a threat to survival. The child learns to adapt to this chronic misattunement through relational patterns such as attention seeking or overattending to the needs of others.

Attachment science has been helpful not only in understanding child-caregiver relationships but also in conceptualizing adult relational patterns. Without intervention, children with anxious, avoidant and disorganized attachment styles can continue to exhibit these patterns in their adult relationships, creating enmeshed, detached or volatile relationship dynamics. But with therapeutic intervention, clients can learn to build and maintain reciprocal relationships, which allows both the client’s needs and the needs of others to be honored and respected. Counseling can also help clients discern safe and unsafe relationships, decreasing the likelihood of repeating unhealthy relationship dynamics established in childhood.

Alicia can now identify her reactivity, practice adaptive self-soothing reactions and connect her triggers to past wounds so that she can begin to practice reciprocal relationships with others. For example, the counselor might suggest Alicia take the risk of planning a social event and inviting others to attend, rather than expecting that her peers will anticipate and act on her desire for connection.

Enforcing boundaries

Reciprocal relationships establish an environment in which boundaries can be set and maintained. Boundaries provide personal guidelines for multiple areas of our life, including our commitments, how we want to be treated by others and how we care for ourselves. Communicating boundaries effectively requires assertiveness, or the ability to clearly communicate one’s needs while respecting the needs and dignity of others. Practicing this skill often requires people to be brave because others may not be receptive to or respect one’s boundaries.

For example, Alicia’s desire for her friends’ approval often caused her to stay out too late, which disrupted her sleep and her ability to arrive at work on time. A personal boundary for Alicia may involve setting a curfew for herself and communicating this to her friends. By keeping her own arousal levels in check and assertively communicating her needs, Alicia creates an environment with less potential for relational harm and higher potential for resolution to relational conflicts.

Managing and repairing ruptures

Every long-term relationship will experience a rupture of connection because of conflict, miscommunication or simply a difference of opinion. How we manage the ruptures determines the level of intimacy and longevity of the relationship. Many people did not have healthy role models in childhood for managing relational conflict. Maybe they watched their parents engage in volatile disagreements or passively avoid conflict; both extremes can make conflict feel threatening and prompt people’s defense mechanisms to engage quickly. It is tempting to avoid conflict and detach from individuals at the first sign of relational difficulties.

Once Alicia has managed her reactivity, moved toward reciprocal relationships and practiced boundary enforcement, she can resist the urge to lash out or withdraw in response to conflict and tolerate the uncomfortable feelings that come from confrontation. Ideally, Alicia would be able to communicate her sadness and disappointment about being excluded from a social event to a safe and trustworthy friend and work toward repairing the relationship. The skills of distress tolerance and active communication enable clients to stay engaged long enough to make genuine repair attempts and invite them to use effective conflict resolution with their partner, friend or colleague. The ability to successfully navigate relational ruptures and repairs builds trust and increases the potential for long-term intimacy in relationships.

Counselors can also model this skill for clients within the therapeutic relationship. In the book Preparing for Trauma Work in Clinical Mental Health, I (Lisa) and Corie Schoeneberg discuss how to have difficult conversations with clients and how to repair the relationship when therapeutic ruptures occur. Regardless of the type of relationship, remaining in the window of tolerance enables us to repair ruptures without defensive reactivity so that we can protect the integrity of the relationship and foster relational intimacy.


The meaningful connection skills pyramid provides a treatment plan for helping clients improve their social skills by progressing along a developmental path. Improving client self-awareness and emotion regulation and their understanding of the connection between past events and current triggers are all foundational interventions for trauma work and other presenting issues, such as marital distress and workplace conflict. Higher-level skills such as reciprocity, boundary work and conflict resolution are invaluable for all relationships and settings. Regardless of trauma history or childhood attachment security, all clients can increase their well-being through improved ability to maintain social connection.


Lisa Compton is a professional counselor with over 25 years of experience. She holds a doctorate in counselor education and is a certified trauma treatment specialist. She is a full-time faculty member in the master’s and doctorate counseling programs at Regent University, an author and a conference speaker.

Taylor Patterson is a doctoral student in counselor education and supervision at Regent University. She is a licensed professional counselor who works primarily with adults with a history of childhood trauma.

Counseling Today reviews unsolicited articles written by American Counseling Association members. Learn more about our writing guidelines and submission process at ct.counseling.org/author-guidelines.

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Forming friendships as a neurodivergent adult

By Samantha Cooper June 15, 2023

Two older women laughing; walking on the beach; one holding coffee; adult friendship


A common misconception about people who are neurodivergent is that they cannot or do not want to form friendships. Although some neurodivergent individuals may choose not to form many (or any) friendships, research now shows that neurodivergent people generally want friends; they just have trouble making them.

“People who are neurodivergent [are] forced to live in a world that is not set up for them and is largely just not accepting of any of their differences,” says Kelly Beck, a licensed professional counselor (LPC) who is an assistant professor of psychiatry at the University of Pittsburgh. This can lead to relationship challenges not only with friends but also with family, medical professionals and colleagues.

In addition, neurodivergent adults are often expected to conform to neurotypical behaviors in social interactions, Beck says. For example, neurodivergent people may have difficulty interpreting neurotypical social cues, which can lead to discrimination if their responses don’t match what society considers to be the “correct” reaction.

Kylie Pilot, a clinical therapist and cognitive rehabilitation specialist at the University of Pittsburgh, has also noticed differences between how neurotypical and neurodivergent people sometimes perceive and experience social interactions. A person who is neurotypical may have developed ways to make up for or buffer socially awkward moments or missed social cues, she says. For example, if a neurotypical person forgets someone’s name, they may be more likely to use context clues to indirectly learn the person’s name or find an appropriate way to ask. A person who is neurodivergent, however, may not be able to notice those social clues as easily (or at all) and may feel uncomfortable asking for the person’s name again.

Pilot is a certified provider for the Program for the Education and Enrichment of Relational Skills (PEERS), an evidence-based social skills treatment for youth with socioemotional struggles developed by UCLA’s Semel Institute for Neuroscience and Human Behavior. The PEERS program works to help neurodivergent people interested in friendships learn skills to navigate social interactions, she explains. The social skills people need assistance with varies, depending on the resources (or lack of) they had while growing up, she adds.

Children often have access to social skill programs through their schools, which can help them navigate friendships, but adults don’t necessarily have the same options. “When you’re young, you think everyone is your friend, [but] … as you move into adulthood people aren’t as kind,” Pilot says. “[Neurotypical adults] have a more solid expectation of what ‘good’ … or neurotypical social skills are. And they have an expectation that other people will also adhere to them.”

PEERS is one of the few intervention services that has a program for young adults (i.e., people between 18 and 35 years old), Pilot notes. This program for young adults teaches age-appropriate social behaviors and responses and offers optional lessons on romantic interactions.

Redefining social relationships

Jamie Kulzer, an LPC in Pennsylvania, recommends counselors, especially those working with neurodivergent people, embrace the social model of disability. This model acknowledges that disability itself is not the problem. Instead, it is society’s unwillingness to provide more flexibility and offer appropriate accommodations that prevents people with disabilities from fully participating in society.

“Ideally, society will change and be more accepting and understanding [of neurodivergence],” Kulzer says. But societal change can be a slow process, and until that happens, she says counselors need to provide their clients with the tools they can use to navigate a world set up by and for neurotypical people.

Kulzer, an associate professor of clinical mental health counseling at the University of Pittsburgh, says that the social model of disability is in stark contrast to the more traditional medical model of disability, which focuses on “fixing” perceived deficits. Many counseling interventions are based on this medical model, she notes. For example, some interventions might ask clients who are neurodivergent to make eye contact when talking to others even though many neurodivergent people find eye contact to be difficult or even painful. This goal of making eye contact was designed with neurotypical people and values in mind, she stresses. It assumes that eye contact is necessary to conversation and ignores the discomfort of neurodivergent people. She advises counselors to use techniques and tools that are designed with neurodiverse people in mind when working with this population.

Unfortunately, many well-intentioned neurotypical individuals believe they are helping people who are neurodivergent by asking them to conform to neurotypical behavior, and they often don’t realize they are causing harm or that their advice is unhelpful because they’re approaching it from their own perspective and experience.

Kenneth Smith, a licensed professional clinical counselor in Ohio, compares teaching social skills to people who are neurodivergent to having someone who easily picks up math concepts explain it to a student who is struggling in this area. “Some people just naturally get math, but most people need to be taught from a bottom-up approach, deductive way,” he says. “The problem is the people who get math … [tend] to be terrible teachers because they don’t get how to teach [it].”

He says this concept applies to social skills as well. “Most people get it intuitively, but that’s the problem — they don’t know how to teach it,” he explains. “If somebody struggles with social skills, they need to be taught a more direct, broken-down version of how to make friends.”

Smith, the founder and clinical director at the Center for Autism, Assertiveness and Social Skills in Columbus, Ohio, advises counselors take a direct approach when teaching neurodivergent clients to make friends by breaking down the steps involved in making friends. He also cautions counselors to avoid giving vague advice such as “just talk to people” or advice that isn’t socially appropriate, such as telling a client to approach a group of people and introduce themselves.

Pilot and Kulzer, who is also a PEERS educator, agree that role-playing is a great technique to use with this population. Kulzer, Pilot and Beck presented on counseling neurodiverse adults who have social skills challenges at ACA’s 2022 Virtual Conference Experience.

Practicing different situations in group sessions or one-on-one sessions helps clients get a better understanding of what to expect when they go out into the real world, Pilot says. For example, if a client is prone to walking away in the middle of a conversation, they could practice this in session with a counselor, who would be able to give them feedback as to why the behavior might not have been appropriate and ask them how they would feel if they were on the other end of the situation.

“Role-playing is helpful because even though every interaction is different, it gives our clients an idea of what to expect or what might happen,” she notes.

Practicing social interactions is especially important for autistic clients because people on the autism spectrum often struggle with relating to others, says David Meer, an LPC at Neurodiverse Counseling Services in Scottsdale, Arizona. Autistic people may be more inclined to make friends with people online through online gaming or apps such as Discord, where they can find people with common interests without having to adhere to the social conventions typically used in in-person settings. For example, people who meet others online do not have to worry about facial expressions like they would if they met someone in person.

“A lot of parents will get upset with them [their kids] and say those aren’t real relationships,” he says. “[But] they are real relationships. Online relationships are genuine connections that sometimes feel safer than in real life.”

In addition, some autistic people get overstimulated when trying to process everything that is going on around them, Meer adds. When autistic people are in a more controlled environment, such as at home playing a video game, then they’re more likely to be comfortable and able to talk to others, he says.

Cultivating intragroup friendships

The theory of the “double empathy problem,” a term coined by Damian Milton (a sociologist who specializes in autism research), suggests that people with different world experiences may have trouble empathizing with one another. This concept applies not only to neurodivergent groups but also to other identifiers such as race, gender and religion.

Meer, who is autistic, finds the term “neurodiverse” to be broad and all-encompassing; instead, he prefers to refer to autistic people as belonging to a “neurominority group.” These groups are formed through shared life experiences and a shared identifier such as attention-deficit/hyperactivity disorder or autism. Like other marginalized identity groups, people who are a member of a neurominority group will generally have an easier time relating to someone within the group than somebody outside of it, he says.

People within a neurominority group are going to better understand the struggle to communicate and will be more accepting of alternative methods of communication, Meer continues. A neurotypical person, on the other hand, may also struggle with communication if they are in an environment where the majority of people are neurodivergent or from a neurominority group.

The double empathy problem highlights that social interactions between people are never one-sided, Beck notes. Because society typically deems neurotypical behavior to be “correct,” she says counselors need to fight these ingrained biases and avoid forcing the idea that the only way for a neurodivergent person to make friends is to act as a neurotypical person by forcing them to perform behaviors they aren’t comfortable with. Instead, counselors can help neurodivergent people find and form friendships within their already-existing social circles.

Finding the right tools

Meer encourages counselors to think outside the box when working with neurodivergent clients, while keeping in mind the importance of identity groups. He shares some ideas about what this type of thinking could look like in counseling:

  • Unmasking: Neurodivergent adults may try to hide or “mask” who they are to fit in. Meer encourages his clients to “unmask” and lean into their neurodivergent identities. He says unmasking is similar to the concept of “radical visibility” in queer theory, which encourages people to embrace and be proud of their identity. For example, he says he “might teach people to lean into their autistic characteristics — what’s natural [to them] … and engage more with [their special interests].”
  • Neurodiverse friend groups: Because it may be easier for neurodivergent people to make friends within their identity group, counselors can encourage clients to form these types of friendships and perhaps even prioritize them over friendships with neurotypical people, Meer says. “[Intra-identity friendships] will show you’re not this ‘weird,’ awkward person and that [who you are] is not necessarily a bad thing. … It’s accepted,” he explains.
  • Group therapy: Meer says that group therapy works well for neurodivergent clients who are struggling with social situations. “Group therapy is good because it’s going to be easier to communicate with people who are of the same identity group, and there’s this baseline of what [neurodivergent people] already understand,” he says.
  • Digital tools: Technology, such as texts, video chats and online multiplayer, can be a useful tool to help neurodivergent clients work on communication and develop friendships, Meer says. Even the new AI tool ChatGPT can help neurodivergent adults with communication. Some of Meer’s clients, for example, struggle with what is appropriate to write in a work email and how to clearly communicate what they want or need, but using digital tools such as ChatGPT can help them write an email or provide them with a template to follow, he says.

Strengthening support

Neurotypical counselors working with neurodivergent clients should learn more about neurodiversity as well as their own biases around social skills and neurodivergence. “You need to listen to clients and really look at your biases if you are neurotypical,” Beck says. “If you are going … to teach neurotypical social skills, you need to think about if that is going to exhaust someone to the point where they have burnout or is [the advice] going to be helpful.”

One way that counselors can challenge their biases is by shifting their thinking around how they communicate with clients. Instead of assuming a client wants to use verbal communication, they can let their clients choose how they want to communicate, Beck suggests.

For example, a client may prefer to write out their responses, or they might feel more comfortable talking while walking outside. Allowing clients to choose the form of communication can help them feel more comfortable and more willing to open up, Beck says. It also might make them more comfortable using these communication methods outside of therapy, she adds.

The other important thing to keep in mind is that the goal of clinical work with neurodivergent clients is almost never to simply “make friends,” Beck says. It’s to build stronger relationships and support networks.

“It might sound obvious, but it is critical to help [neurodivergent] people find networks of people that … accept them for who they are, [that] they enjoy being around and … that they find restorative and not depleting,” she says. Social relationships should bring clients joy and happiness and not be exhausting for them.

Some adults might also want to develop and maintain romantic relationships, learn the social skills necessary to succeed in the workplace or just learn to regulate their emotions in social situations that might otherwise be overwhelming, Kulzer notes. And some neurodivergent adults don’t want friendships at all, and that’s OK. It isn’t the counselor’s position to decide if a friendship is what the client needs to be happy. But if a client does want to improve their social skills and friendships, then it’s the counselor’s job to give them the tools they need to achieve their goals without the counselor imposing their own ideas of what a relationship should look like, she says.

“Everyone wants friends for a number of reasons,” Smith says. “We’re social animals. We want to be with people. … It doesn’t matter if you’re neurotypical or neurodiverse. … Love and friendships are where we find purpose and meaning in our life.”


Samantha Cooper is a staff writer for Counseling Today. Contact her at scooper@counseling.org.

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Tough love: Supporting parents of children in unhealthy relationships

By Katie Bascuas December 7, 2022

Most parents would do anything to protect their children from pain. So watching a child struggle with an addiction, whether to a substance, behavior or even a relationship, can be an excruciating experience and bring up feelings of guilt, grief, self-doubt, worry and isolation. This situation becomes trickier when the child becomes an adult because parents can no longer intervene or make decisions on behalf of their loved one. 

Most people understand the challenges that surround having a child who struggles with a substance addition, but having an adult child in an unhealthy romantic relationship or a relationship in which there may be emotional abuse, such as inappropriate use of control, disrespect or dishonesty, is often considered less “taboo” or more acceptable than a substance addiction. Most people desire the feeling of being loved and accepted, including in romantic relationships. Therefore, parents can sometimes feel helpless when they think their child may be in a toxic and painful relationship.

“I’ve got half a dozen people I’m working with right now who are dealing with this, and my encouragement to someone who has a loved one in an unhealthy relationship is that it’s going to be difficult to talk them out of it because it’s just not rational,” says Ronald Laney, a licensed professional counselor (LPC) at Change Inc. in St. Louis. “The other person is going to feel that that relationship, whatever it is, is filling a void that started long, long ago.

For counselors, supporting these parents can look similar to working with clients who have loved ones struggling with an addiction. There may be questions around how much to get involved, whether to distance themselves from their child or if they’re doing the right thing. 

And depending on the parent-child relationship, helping parents to understand and accept the situation could be challenging. For example, there may be years of unhealthy patterns of co-dependent and enabling behaviors that inadvertently perpetuate and reinforce the child’s addictive patterns, says Laura Whitcomb, an LPC who owns and operates NoCo Counseling in Fort Collins, Colorado.

“Parents are willing to do and give everything for their kids,” Whitcomb says. But “they’re often trying to control someone else’s behavior and ensure someone else’s well-being, and that person is not making those same choices.” 

Counselors can play a key role in helping parents better understand what their child may be experiencing as well as normalizing the parents’ feelings and experiences and helping them reach a place of acceptance of the situation so as to ensure their emotional and mental well-being. 

Meeting clients where they are

While it might seem like a no-brainer, Whitcomb says one of the most important things to remember when working with parents seeking support around an adult child’s unhealthy relationship is to meet those clients where they are, but she admits this can be challenging. 

“I care so much that sometimes I get ahead of myself,” Whitcomb says, noting that she has to sometimes stop herself from giving advice or providing feedback that clients may not yet be ready to hear. “I really want [the clients] to be OK. I want them to get some joy back in their lives, and I want them not to be taken advantage of and have all this responsibility that isn’t really theirs. Some of these parents should be looking toward retirement or traveling, and they’re just sacrificing everything.”  

Because counselors are trained to examine the big picture, they may recognize things that may benefit the client before the client does, notes Robin Witt, an LPC and director of relationship dynamics at the Better Institute in Pittsburgh. “My biggest piece of advice is meeting the client where they’re at and working at the pace that they feel comfortable because, especially in these trickier situations, we can see the solutions but they’re not always willing or ready to see it, and if we push it, we can lose the client,” she says. “They could get scared or intimidated, and the biggest thing that we can do for them is to be a validating, supportive resource. We might be the only person that they’re talking to about this, and … what’s most important is keeping that professional relationship safe.” 

Witt focuses on client goals and knows that change can be gradual because clients do not have control over their loved ones. And truly accepting the fact that they may not be able to change the situation to the degree that they would like often takes time. “This is not a four-sessions-and-they’re-done thing,” she explains. “So keeping a slow pace and being mindful that the client is the driver is important.” 

Whitcomb says she has to remind herself as much as her clients that she may be getting ahead of them and that the process of learning how to support and engage with a loved one in an unhealthy relationship — similar to someone with an addiction is often long and complicated. She uses frequent check-ins and asks clients what changes seem manageable to them and what they are thinking and feeling in order to gauge where they are and what they want to accomplish as well as to help them set reasonable expectations. 

Some clients, for example, may take quick or impulsive action to try and fix or ameliorate the situation, such as giving ultimatums to their loved ones, but Whitcomb says those types of actions often just push the child away and have the potential to hurt the relationship. “A lot of people seem to want to do that. They want the problem to be solved. Most of us do,” she says. “So really try and shift their focus back to themselves, less on the unhealthy person and more on them.”

Whitcomb says she draws from her experience growing up with parents who had substance use issues to help clients learn to redirect their focus to themselves. It took her several Al-Anon Family Group meetings before she realized that focusing on herself, not her parents, was one of the first steps toward healing.

“It took me four meetings before I realized, ‘Oh, these people are no longer consumed with what their addict is doing. They are focused on their own lives and rebuilding their own lives,’” she recalls. “It took me a while to get it because people are holding so much intense emotion. We’ve been hurt a lot. That lightbulb doesn’t go on just overnight.” Whitcomb says that she uses this insight to prevent herself from getting ahead of clients as well as to help explain to clients the common tendency to focus on the other person.

The importance of psychoeducation

Another helpful component of supporting parents whose adult children are in unhealthy relationships is psychoeducation, which can include accurately labeling unhealthy or abusive relationships and modeling empathy and understanding.

Witt admits there can sometimes be a fine line between educating clients and validating and supporting them. The clinician, for example, wants to acknowledge the client’s experience and how painful it may be, but they also want to help the client understand the reality of the situation, which may involve exploring uncomfortable truths such as the fact that their child is likely unaware of or unwilling to accept that they are in an unhealthy relationship and subsequently are likely in denial about the effects that the relationship is having on other family members. 

Witt finds that naming and defining abusive relationships can help clients better understand what a loved one might be experiencing. Depending on where the client is at, this can be incredibly validating in the moment, or it might be information that clients come back to in the future. “Giving them the vocabulary can be important because we might only get that client for a short time,” Witt notes. “We’re planting seeds. Someone else is watering them, and we also might be watering seeds that therapists or others have been planting and watering.” Then, if the child becomes more open to discussing their relationship or relationship dynamics down the road, the parent will be more prepared to help their child see and understand some of the unhealthy patterns taking place, she adds.

Clinicians can also teach parents the importance of meeting their child where they are, while also modeling this behavior within the therapeutic relationship, says Laura Copley, an LPC who owns and operates Aurora Counseling & Well-Being in Harrisonburg, Virginia. 

“If I was seeing a mother whose son or daughter was coming home from college and all of a sudden in this toxic or manipulative relationship, I would first need to help teach her how to slow down enough to recognize where her child is at,” she says. To do this, Copley may use open-ended questioning to encourage the mother’s exploration into her child’s mindset. For example, she may ask the client questions such as “What do you think your child is experiencing right now? How do you know your child is experiencing that? What are some of the things they’re showing you that is making you feel like this is how they’re connecting to this relationship? And if that’s the case, what might be something your child needs to hear first from you?”

Copley also advises clients to show an interest in their child’s partner by asking how that person is doing and demonstrating concern for the partner’s well-being. Clients “don’t like this part, but it works,” Copley admits, because it’s a way to show genuine concern and hopefully create a safe space where the child can open up about their own well-being without getting defensive or reactive. “The son or the daughter then starts to trust, starts to feel safe, starts to express what they’re experiencing,” she explains. Then parents can reassure their child that if something bad happens in the relationship, they can stay with them, no questions asked.

Copley says that it can also be helpful to teach parents about the positive and negative personality characteristics that are often present in someone engaging in an unhealthy relationship. For example, a person may identify as being a “savior,” so they are loyal, committed, loving and courageous. On the other hand, saviors are also prone to attracting others who “need” saving, so they may also have a fear of asking for their needs to be met or a fear of being vulnerable or getting hurt, she notes. 

“This is all part of the conversation that we could have with parents to help them understand how to bridge the mindset of where their child might be,” says Copley, who adds that she would also role-play and model various ways to approach the loved one. “How we approach another human being, even somebody like our child, around something like this will deeply influence how they receive the message.”

Setting healthy boundaries

Working with clients to set healthy boundaries is another important aspect, but it can be incredibly challenging. 

To overcome difficulties with boundary setting, Laney encourages clients to think of it as setting a boundary not only for themselves but also for their loved ones. For example, he says that parents could tell their child, “Out of my care for you, I’m going to set this boundary because it’s not doing you any good to allow you to continue to treat me in that manner.” Framing the boundary as a means of protecting the child has helped many of Laney’s clients overcome their hesitancy to set boundaries. 

Another challenge with setting boundaries, especially in the beginning, can be finding the right balance. Clients sometimes move from having no boundaries to the extreme, Laney notes. For example, a parent may go from talking to their child every day to cutting off communication completely, rather than just communicating less. “We have to find that sweet spot,” Laney says.

Therefore, it’s important for counselors to help clients understand the nuance of boundary setting as well as the feelings of guilt and anxiety that can come along with setting limits with loved ones. Witt says that she encourages clients to make values-based decisions around things such as finances, faith, career and physical well-being when setting boundaries to ensure greater success.

“Making values-based decisions leads to those boundaries that actually stick,” Witt explains. For example, a parent may value attending church every Sunday, so if their child asks them to watch their grandkids one Sunday so that they can spend time with their partner, the parent may feel more empowered to say no because it will be a values-based decision. 

“If it’s values based, [the client] is more likely to uphold the boundary versus something they feel they ‘should’ do,” Witt says. “And setting a boundary that’s not going to stick is not going to be helpful to anybody.”

Dealing with guilt, grief and shame

There’s also the possibility that parents will feel a sense of guilt while watching a child in an unhealthy relationship dynamic and wondering how their parenting style or the child’s upbringing might have contributed to the situation. 

“The reality is that … our early attachment styles can absolutely set the stage for what we expect in romantic relationships, how we expect to get treated, how we get our needs met and if that’s replicated,” Copley says. So she likes to keep clients who may be experiencing these feelings of guilt focused on the present and what they can do now as opposed to exploring past events, at least when it comes to their goal of helping their child. 

Copley refers to having clients focus on what they can do in the present as a corrective experience, one in which behaviors and dynamics from the past can be corrected in the present by making another choice and behaving differently. For example, if a parent avoided tough conversations with their child in the past because of their own discomfort around confrontation, they could decide that moving forward they will be more open to having difficult conversations with their child. 

“If there’s shame and guilt for something the [parent’s] recognizing, we can either spiral into that shame and guilt and once again make it about us,” Copley explains, “or we can say it’s a signal that another opportunity is present for you to do something different and get redemption over anything that happened in the past.” 

Copley also teaches clients how to better manage the uncomfortable feelings that their child’s relationship may be bringing up in them by using somatic techniques to decrease the chances of reacting out of fear and trying to control the situation. Often, “the storm of emotions that are more than likely in them is because they’re so afraid of what their child is going through and the pain that they must be going through,” she explains. “And if we project that fear onto someone who thinks they are in love, that’s going to push them away and make them protect the toxic person more.” 

Sometimes parents feel guilty because they were also in an unhealthy relationship when their child was growing up. Witt advises clients who are worried their child may have witnessed unhealthy relationship patterns from them to have an honest and transparent conversation with their child about it. “We can’t go backwards, but we can be mindful of what we can do today to move forward,” she notes. “Whether that’s an apology or having an age-appropriate conversation to explain ‘This is why I handled things the way I did,’ [it] can enhance the relationship that you now have with that adult child.”

To help clients work through some of the shame and guilt that they might feel in these situations, Laney says that he likes to reinforce self-compassion and will often work with clients to explore how they can accept both difficult emotions and realities. For example, he might work with clients on how to hold the sense of sadness that their child might be in an unhealthy situation with possible feelings of guilt as well as possible disappointment around the dynamics of the relationship they have with their children. 

Accepting what you can’t change 

Although it’s not easy to come to terms with potentially challenging realities, such as a child’s unhealthy relationship and its effects on the wider family, embracing a certain amount of acceptance and equanimity can be one of the healthiest solutions for these clients, Laney says. 

“At some point there’s almost a surrender,” Laney says. “We exhaust ourselves trying to change things that we really can’t change. There’s something of a letting go there.”

Whitcomb also emphasizes acceptance, especially self-acceptance, in these types of situations that often involve an element of codependence or a preoccupation over the child and the child’s relationship at the expense of parent and their well-being. “Codependence feeds on avoidance of one’s own needs and difficult emotions because by being consumed by the problems of another, we are better able to ignore and avoid encountering our own,” she explains. “As I encourage parents and family members to shift their focus from the person they are enmeshed (overinvolved) with, I also try to guide clients to identify their own strengths as well as parts of themselves they perceive as flawed.” In recognizing their strengths and taking time for self-care, clients can start to develop not only a healthier sense of confidence and independence but also more self-compassion, she says, which in turn can cultivate more compassion for others.



Contact the counselors interviewed in this article: 



Katie Bascuas is a licensed graduate professional counselor and a writer in Washington, D.C. She has written for news outlets, universities and associations.


Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Counseling a broken heart

By Bethany Bray August 24, 2022

Romantic breakups can be a painful process that often involves feelings of loss on many levels.

According to Jessica Rizk, a licensed professional counselor and supervisor who owns a private practice in Northern Virginia, initial feelings of loss after a breakup can occur in two phases, the first of which is the loss of routine. A person may acutely feel the loss of activities that brought them comfort and connection such as phone calls and texts from their partner, watching their favorite TV shows together or their usual morning coffee time.

As the breakup begins to sink in, the person may feel loss over what could have been, Rizk continues. This second phase may bring painful feelings about unmet expectations and the absence of a future with their partner — either one they imagined or one they discussed and planned as a couple.

These multifaceted feelings of loss can intertwine with anger, disappointment, vulnerability, regret, shame, betrayal, self-doubt, loneliness or even relief. In short, there can be a lot to unpack in counseling.

Rizk, a member of the American Counseling Association whose practice focuses on helping clients with relationship issues, recommends counselors start by offering empathic listening, which, she says, these clients need first and foremost. There is healing in being truly and completely heard, she notes.

“Clients may not feel they have the opportunity to get it all out to friends and family without judgment,” she explains. “Having an opportunity for the client to speak completely unfiltered is my main goal. Counseling is about talking about pain without judgment — even if they need to talk about something over and over.”

Although post-relationship heartbreak is not uncommon, Rizk aims to treat each client who seeks counseling after a breakup as if they are going through a new and unique experience. This includes prompting them to share how they met their ex, what drew them together and other details of the relationship, including its end. It’s important for clients to talk through the breakup — when they are ready — so they don’t get “stuck” in feeling angry and relying on unhealthy coping mechanisms, she says.

As clients share, Rizk says she tries to stay as neutral as possible and reassures the client that they will not feel the sadness, anger or any other feelings they are experiencing forever. She often needs to gently explain to clients that they may never know what caused a breakup.

“Depending on how vulnerable and open the client is, some of them are coming to counseling to figure out the why. Others are unhappy with being single or are looking to figure out why it [painful breakups] keeps happening and they jump from relationship to relationship,” Rizk says. “I try and listen to their stories and pull out threads to bring into sessions and gently process together. … Each client will cope in a different way, and my desire is to walk alongside the client as if I’ve never heard this pain before.”

Wondering why

Clients sometimes come to counseling after a relationship ends to seek closure, says Kelly Weber, a licensed professional counselor (LPC) who sees individual clients at her private practice in Phoenix, Arizona. They are often looking for help to move through a painful period that is full of difficult emotions and unresolved feelings about the relationship and its end. It can be a confusing and hurtful experience, she notes.

This can especially be the case, Weber says, if the breakup was unexpected, such as the discovery of infidelity, or the other person ended the relationship without much explanation. Inadequate closure — that feeling of having the rug pulled out from underneath you — can cause a person to replay scenarios over and over in their mind, wonder what happened, and question if it was their fault, she says.

For clients with a preexisting mental illness, a breakup can exacerbate their symptoms, especially rumination, self-doubt, intrusive thoughts and overthinking the “what-ifs,” Weber says. For some clients, this can lead to depressive episodes, trouble sleeping, weight loss or gain, isolation/withdrawal and distress to the point where it interferes with daily life. She has seen clients get to the point where their thoughts about the relationship and breakup are all-consuming and they are unable to get out of bed or meet their work responsibilities.

As with any client who is experiencing intense distress, Weber says that it’s important to ask clients who are experiencing a breakup about suicidal thoughts, including hopelessness or feeling like they can’t go on without their partner. In her experience, it’s not common for clients to answer in the affirmative, but “it’s important to ask the question,” she says.

Marquita Johnson, an LPC with a solo private practice in the greater Atlanta area, also notes that many of her clients are seeking closure when they come to counseling after a breakup. She reminds them that closure doesn’t have to be about getting answers from their ex; closure is for them, she says. 

To keep this focus, she often suggests that clients who are looking for answers about why a relationship ended write out their thoughts and feelings in a journal or compose a letter or email to their ex that does not have to be sent. She prompts them to reflect on what did and didn’t work for them in the relationship.

Johnson also provides psychoeducation on how clients may regress when they are triggered by contact with an ex or by something that reminds the client of the relationship and the time they spent together.

“They need to understand that it can be a roller coaster,” Johnson explains.

Johnson adds that clients may also need psychoeducation on how social media can trigger and worsen negative thoughts if a client continues to follow or look at an ex’s posts. She often spends time explaining that although it’s tempting to keep tabs on their ex’s life through social media, seeing their ex’s posts can prolong post-breakup pain and cause them to compare themselves or jump to conclusions on whether their former partner is happy or remorseful.

Working through loss

Kristyn Macala, a licensed professional clinical counselor at a trauma therapy practice that offers online counseling to clients in Ohio, stresses that these clients need a supportive and gentle approach. If a counselor tries to put a positive spin on the breakup, prompting the client to identify good things that came out of a relationship before they are ready, they are likely to stop coming, she says.

Instead, Macala tries to create an environment for these clients to “feel however they need to feel” after a breakup.

“For me, the most important thing is creating the space, the rapport and the connection [with a client], so they feel comfortable and know that we can take our time, and that’s OK,” says Macala, who specializes in sex and couples counseling.

Macala uses psychiatrist Elisabeth Kübler-Ross’ five stages of grief model with clients experiencing heartbreak. When describing this concept to clients, she refers to these five stages as “tasks of mourning” because even though their ex is alive, they are still mourning the loss of a person they loved. Kübler-Ross’ model can help them accept the reality of the loss and the pain that comes with it as well as come to terms with a world where they are no longer a partner to that person, Macala explains.

“If the relationship was a ‘first’ in some way (e.g., first relationship, first relationship with a partner with a certain identity or characteristics, first sexual partner or committed partnership), the loss may be particularly painful because they likely had expectations and dreams that were unfulfilled and made personal sacrifices to invest in the relationship,” says Naomi J. Wheeler, an assistant professor and director of the Family and Relational Stress and Health (FReSH) Lab at Virginia Commonwealth University.

It can be tempting for a counselor to try to make a client feel better after a breakup, but the best support is the kind that honors all feelings as valid in the process of healing and taps into the client’s own internal wisdom, says Wheeler, an LPC in Virginia and a licensed mental health counselor in Florida. This includes the ups and downs of vacillating between hating a former partner and loving them, feeling lost and lonely, or feeling free and empowered.

Rizk often prompts clients to describe and explore their feelings of loss by asking them to tell her the story of their relationship, from beginning to end. This gives counselors an opportunity to listen for “sticking points” that may need further attention later in therapy, she explains. In fact, the language they use to describe their situation often provides a lot of context, Rizk says. For example, she listens for phrases such as:

  • “I don’t know what’s next.”
  • “I don’t know what to do with myself.”
  • “I feel like I’m never going to find anyone else.”
  • “I’m going to throw in the towel and stop dating.”
  • “I have never not been with someone.”
  • “I don’t know how I’m going to bounce back from this.”
  • “I don’t know how I’m going to tell my family.”
  • “Without my partner, I’m not strong enough.”

Clients who use this type of language often need to focus on their identity and self-worth in addition to grief work in counseling, Rizk notes. It may also indicate that they struggle with a fear of loneliness or have previously relied on a partner to find happiness or fulfillment. These feelings may be further complicated if a client comes from a culture or family system that places value and importance on marriage or couplehood over singleness, she adds.

“There can be a sense of confusion on ‘what now’ or ‘what’s next.’ They invested so much in the relationship that they forgot to invest in themselves,” Rizk says. “There is a lot of grieving, but how they grieve can be very telling of how they view love, [including a reliance on] external love instead of self-love.”

Quelling negative thoughts

It’s easy for clients to fall into negative thought pattens and ruminate on the what-ifs after a painful breakup. So helping clients become aware of this inner “script” is a vital first step in counseling, Macala says, as well as equipping them with tools to stop and reroute intrusive thoughts. When left unchecked, unhealthy thoughts can intensify other mental health challenges such as depression and anxiety.

“When those [negative] thoughts are swirling in our brain we can really get down on ourselves,” agrees Kasie Morgan, a licensed clinical mental health counselor and supervisor at a practice in Mount Holly, North Carolina. She’s noticed that clients often respond by questioning themselves and asking, “What did I do? What doesn’t this person like about me? Why does this always happen to me?” The first thing she helps clients do is redirect the focus by telling them, “This is not about what is wrong with you; it’s about what happened to you.’”

Morgan also finds that helping clients to forgive themselves can be an essential part of healing. A person’s self-talk often defaults to “should” statements, such as “I should have known the other person was going to hurt me or treat me poorly.” These clients often need to hear (sometimes repeatedly) from a counselor, she says, that nothing they can do will control or change the behavior of another person — all they can do is focus on their own actions and thoughts. 

“That is a hard concept to work through,” Morgan admits. “A lot of times when we talk about a breakup or dismantling a relationship, there’s a lot of talk about forgiving the other person. But we forget to talk about forgiving ourselves for our shortcomings and our patterns. Part of the process is letting go of the things within yourself that have driven you to a place of not liking yourself. Being kind to yourself is vital.”

Morgan uses acceptance and commitment therapy techniques with her clients to help them build resiliency and learn to separate fact from fiction in their thought patterns and emotions. She asks clients to identify the residual feelings they have from a past relationship (e.g., despair, sadness, relief). Then she helps clients put those feelings in context by pointing out a positive fact or aspect that came out of the relationship. For example, she may note that the client devoted a lot of time, energy and emotion to this person and relationship and prompt them to explore it further by asking themselves, “What are the facts about me that have come out of this relationship?” 

Rizk also says that cognitive reframing techniques are her go-to for clients who are spiraling into negative thought patterns after a breakup, including feeling that they have somehow failed or are “not enough.” She supplements this work by prompting clients to make a list of things that they are good at or have been successful at outside of their love life. Clients can also ask supportive friends and family to help them identify some positive qualities and accomplishments that they can add to the list, she says.

When Rizk discusses the client’s list with them in session, she emphasizes that they are worthy of love and have a lot of be proud of. Positive aspects of a client’s life, such as work accomplishments or valued friendships, can often be forgotten or put aside when a client is in a romantic relationship, especially one that is falling apart, she notes.

The language that clients use when describing their negative thought patterns can also uncover core beliefs that need to be explored and challenged in counseling, Macala says. This includes catastrophizing or making generalizations such as “bad things always happen to me,” she adds.

Macala says she gently broaches these conversations about core beliefs, and she doesn’t delve deeper into the issue with the client until after they have moved past their initial emotional response to the breakup, are stabilized and indicate they are ready to discuss these beliefs further. She begins by talking about what core beliefs are, giving examples such as “I am unworthy” or “I am helpless,” and explaining that some of them can come from negative things we’ve heard in our formative years. She then asks clients, “Does any of this sound familiar? Does it resonate with you?” And she says they often respond “yes.” 

“I don’t challenge them right away,” says Macala, who estimates that one-third of her caseload is struggling with some kind of relationship loss or grief. “This person has believed that two plus two equals five their whole life and I’m telling them that two plus two equals four, and it’s upsetting. … Sometimes it takes a lot of work to exchange them [core beliefs] for something more helpful.”

Macala says that the cognitive behavior therapy technique of reframing, which is strengths-based, can be particularly helpful for clients who disclose catastrophizing thought patterns and beliefs such as “I can’t do anything right.” 

Exploration of core beliefs and reframing helped a male client that Macala once worked with who came to counseling after the end of a long-term relationship. His partner had cheated on him, and the client was navigating a lot of pain, denial and a need to mourn the loss of the relationship and the long-term plans he had imagined with his partner.

His presenting concern was depression, she recalls, but as they began to work together it became apparent that the breakup was exacerbating not only his depression but also his substance use.

Initially, Macala worked on thought stopping techniques with this client to quiet his rumination and equipped him with healthy coping mechanisms, such as positive affirmations and gratitude journaling, to turn to instead of substance use. Once he was stabilized, they began to focus on his values, and it became clear that undergoing childhood abuse and abandonment by his mother had caused him to believe that he was unlovable, Macala says.

She challenged this belief by asking the client to write out a list of his values. For each value that had a negative connotation, she asked him to think of a positive one to match it. From there, she suggested the client put the positive values on a vision board to look at and remember each day.

“Negative beliefs focus on what isn’t there,” Macala says, “and reframing flips it to focus on what is there.” 

Rediscovering self

We often invest a lot of our time and resources in our relationships, and as a result, we can wrap much of our identity and sense of self into a significant relationship or partner,” says Wheeler, an ACA member who specializes in family and relational stress. “So, when the relationship ends, a person may grieve the loss of the partner, the loss of the life built together, as well as the future they had imagined, and begin a process of rediscovering themselves outside of the partnership.”

Wheeler and the other counselors interviewed for this article emphasized that clients can benefit from counseling work that guides them to explore and reconnect to their identity after a painful breakup. A first step can be to ask the client to identify hobbies, interests and social supports — including those which they had abandoned during their relationship — that they want to connect or reconnect with.

For Weber, this focus on reconnection to self often comes after she’s done grief work with a client and they have moved forward from an initial state of vulnerability and sadness where, in some cases, they’re crying all the time. She often explains this concept by describing it as “working on version 2.0 of themselves.”

Weber finds that dialectical behavioral therapy techniques can be helpful to give clients a new perspective after a breakup and boost confidence. In particular, she uses role-play to build communication skills and to help clients better express their needs.

Morgan also recommends counselors help clients who are going through a breakup identify and explore their core values and beliefs, including values that come from their family of origin. There are numerous values worksheets available at therapistaid.com that are helpful in this realm, she notes.

She advises counselors to help clients identify what values they want to closely examine and how those values affect their ability to be a romantic partner. “It’s important to identify not only [clients’] current values but also what they want them to be,” she says. “For example, I might want to have creativity in my life but right now I’m working at a job that isn’t creative.” 

“A lot of values are generational, so it can be helpful to see how they impact your life and play out in your own values,” she adds.

Johnson specializes in counseling the millennial population, especially with dating and relationships, and often spends a lot of time helping clients to identify and strengthen their identity and values after a breakup. She created two sets of cards related to relationships that she often uses in session with clients recovering from a breakup. The first set of cards prompts conversation on what a client wants for themselves in a relationship, with questions such as:

  • What did your mother or father teach you about relationships?
  • If your relationship was a traffic light, would the signal be green, yellow or red, and why?
  • How do you know you feel safe in a relationship?
  • If you had the relationship of your reality, what would that look like? (Johnson says she purposely uses the word “reality” here instead of “dreams” to keep clients from imagining or dwelling on a false reality.)

The second deck of cards contains a series of relationship affirmations for counselor and client to repeat together and talk through. Some of the affirmations include: 

  • The success of a relationship is a shared responsibility, based on trust and vulnerability.
  • Healthy control is having both self-control and the remote control. (This affirmation interjects a little humor and usually sparks a laugh before diving into the heavy topic of self-control, Johnson notes.)
  • When I’m in conflict with my partner, I am actually looking to connect with them.

In addition to the card prompts, Johnson also has clients identify and write lists of negotiable and non-negotiable aspects that they value in relationships and areas they are working on (e.g., self-confidence) to track and discuss in counseling. 

Having clients focus on themselves during this phase of therapy, Johnson says, often reveals the need to work on skills such as communication and assertiveness, as well as the need for psychoeducation on the different types of attachment styles and how that can influence a person’s romantic relationships.

Johnson notes that these conversations can also prompt wider discussions about what the client views as a healthy relationship, when and how they feel safe to become vulnerable with a partner, and what they’ve learned and internalized from their own relationships as well as others’. And it shifts their focus to realize that they have the power to set boundaries for the choices they make with romantic partners in the future, she adds.

Making meaning

With their relationship in the rearview mirror, an important part of the healing process is for clients to reflect and create meaning from the experience. However, “there’s no easy way to do that,” Macala admits. “We have to approach it from the perspective of putting ourselves in the driver’s seat. We get to decide what we are going to take from it [the relationship].”

Although this is an essential part of counseling after a breakup, it should come after a client has processed the loss and is ready to reflect on the entire relationship, including its painful end, Macala says.

The ultimate goal should be to guide the client as they identify what was good and healthy in the relationship. “Then, we discard whatever was unhealthy and what we don’t need anymore,” Macala says. Take, for example, a client who experiences a bad breakup with someone they have a child with; rather than thinking about the negative parts of the breakup, the client could choose to focus on the fact that this relationship also gave them something positive: their child.

One approach that Macala uses to prompt these discussions is to have the client make a list of things that were red and green flags in the relationship. Clients are often familiar with the idea of red flags in a relationship, such as jealousy or controlling behavior. Conversely, green flags can include things such as finding a partner who enforces healthy boundaries in their life or has good social supports. Macala suggests clients make meaning from their past relationship by expanding their thinking to include both the red flags they want to avoid repeating in their next relationship and the green flags they’d like to seek out.

Weber agrees that a counselor can help clients make meaning from the good and the not-so-good aspects of an ended relationship. She finds it helpful to spur these conversations by having the client draw a line down the middle of a blank piece of paper. On one side, they list all the things they will miss about the relationship, and on the other side, they include all the things they won’t miss.

“Through the grieving process, we are able to recognize both sides of that piece of paper,” Weber says. “We do not want to romanticize it [the relationship] or put it on a pedestal but have a realistic view of what happened.”



The need for self-love

Clients who are healing from a painful breakup often ask their counselor when they should start dating again. There is no “right” answer to this question, and a professional counselor shouldn’t advise a client on what they should or shouldn’t do, but it’s an important topic to talk about, notes Kelly Weber, a licensed professional counselor (LPC) with a private practice in Phoenix, Arizona. Weber uses the question as an opportunity to explore why — or why not — a client feels they are ready to date again. 

Jessica Rizk, an LPC who owns a private practice in Northern Virginia, says that clients’ questions about when to start dating again often have some underlying reasons. If it’s because they are uncomfortable with being single, they may benefit from unpacking those feelings in therapy.

Rizk has worked with clients who dove back into dating and relationships soon after breakups because they were unable to tolerate feelings of loneliness and vulnerability and struggled with self-love. These feelings can stem from abandonment or negative experiences in their past, including childhood, she explains.

“They are attracted to feeling loved by someone,” Rizk says. “The reality is that they’re trying to fill a bucket with a hole in it. It’s not their partner’s responsibility to fix their bucket.”

Rizk helps clients work through these issues, explaining that a relationship is doomed if one of the partners is seeking connection to meet a need, such as self-love, that only they can meet themselves.

Clients may avoid talking about a breakup or blame others for relationship problems because they fear loneliness or feel they are unworthy of love — all of which can be processed in counseling, adds Marquita Johnson, an LPC with a counseling practice in the greater Atlanta area.

“Their identity is often enmeshed with being a part of a couple,” Johnson says. “I tell clients, ‘A single dollar bill still has value even though it’s alone. It is not valueless if it’s not with other bills.’”

She sometimes assigns these clients “homework” by asking them to do an activity by themselves (e.g., eat in a restaurant or attend a social gathering alone) and then write in a journal to process the experience. She prompts them to think about how they felt during the activity and, in turn, what value can be found in being single and doing things on their own.

Kasie Morgan, a licensed clinical mental health counselor and supervisor at a practice in Mount Holly, North Carolina, agrees that a counselor’s role can include helping a client explore their thoughts and feelings related to relationships after a breakup as well as whether they are ready to begin dating again and take on the “heavy work” of being in a partnership.

Entering another relationship “is a heavy thing and they need to work through their connection to self before” they’re ready to date again, Morgan says. “Until they are happy with where they are in life, it’s going to be increasingly difficult to find a relationship and be fully committed to that person.”



Bethany Bray is a senior writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.


Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Voice of Experience: The search for intimacy

By Gregory K. Moffatt August 17, 2022

Humans are social creatures, no doubt. But we run the spectrum from the intensely introverted (like I am) all the way to the expressly extroverted (like the rest of my family). Isolation is often a necessity for introverts who need to recover from the energy-draining, crowded workdays.

But for extroverts, being immersed in their work and sitting at a desk all day, even if they are surrounded by people, requires them to seek out social time. All three of my adult children are like that. After a long day at work, they still want to go out to museums, clubs and parties. It exhausts me to think about it.

But what we all have in common isn’t just our social nature, varied as it is. Intimacy — a component of our social nature — is what we really seek.

Erik Erikson brought the term “intimacy” into our clinical vocabulary in the first half of the 20th century with his eight stages of psychosocial development. The sixth stage of his theory teaches us that we reach a critical juncture in our 20s: We either learn to be intimate or we find ourselves feeling isolated until we do. Some people, according to Erikson, remain stuck in this stage, doomed to live out their days feeling empty.

A shallow reading of his theory might lead one to suppose he only meant romantic relationships. I am sure that was a part of what he had in mind, but intimacy is so much more than that. Intimate relationships encompass both platonic and romantic relationships, and they are ones where individuals are free to bare their souls and to know that their secrets will be safe and understood.

The most satisfying marriages are intimate marriages, but intimacy isn’t just physical. In fact, any sex therapist could tell you that people often substitute sex for intimacy. But sex can be safer than intimacy because it doesn’t allow one to be as easily hurt or betrayed.

Robert Sternberg, an American psychologist, helps us understand the difference between intimacy and sex even better in his triangular theory of love. This theory teaches us that the most loving relationships are those that balance intimacy, passion and commitment. Intimacy is the sharing of self, whereas passion is the physical attraction of a relationship.

A relationship can have a passionate physical life yet be devoid of intimacy. Clients often say, “My spouse never talks to me.” When I want to test for intimacy, one of my quick go-to questions is, “What is your spouse most afraid of?” If the client can answer that question, they have at least some level of intimacy.

Think about the many ways we demonstrate our need for intimacy. We take pictures, not just to remember the moment but to share them with others. We are saying, “Look at what is important to me. Do you understand me?”

We touch. Holding hands, a pat on the arm or a high five are all ways of being intimate. We are allowing others into our space or moving into other peoples’ space for the sole purpose of letting them know, “I see and understand you.”

We tell stories and jokes. With this exchange, we are trying to illicit a response from the other person. We want them to notice what we enjoy or find funny.

If you don’t believe me, think about the last socially awkward moment you had where someone didn’t care about a picture you shared, didn’t appreciate your touch or didn’t laugh at your joke. I bet it left you feeling empty — just as Erikson said it would.

Navigating intimacy is a lifelong task. Our biggest fear is being rejected — having someone betray our risk of intimacy. Dysfunction occurs when we don’t know how to be appropriately intimate or we stop trying.

So many clients have passed through my door struggling to repair damaged relationships or contemplating divorce. “I’ll never marry again,” they often say, and I know in that moment, they believe it.

But I also know that feeling may pass because being completely isolated will not fulfill their need for intimacy. People don’t have to remarry or even date for that matter. But when one is hurt so deeply, it is easy to generalize pain and avoid intimacy with anyone. And that, my friends, is the antithesis of being human.

As counselors we often need to help our clients discover intimacy in healthy ways. Pornography addiction, affairs, substance use and careers can be substitutes for intimacy. People with calloused hearts who are afraid of being hurt may pretend they don’t need anyone else, but we know better. That kind of self-protection is understandable, but it robs one of their humanness.

Everton Vila/Unsplash.com



Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.


Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.